Strategies for Coping with Sensory Hypersensitivity

If it seems like your sense of touch, taste, smell, hearing, or vision is extra sensitive or heightened after your brain injury, it’s not your imagination. Sensory hypersensitivities are another major, yet not as obvious, contributor to fatigue and overload after brain injury. What we experience with our senses is essentially more information for our injured brains to try to process and organize. You can have difficulties processing sensory information just like any other information in your brain. Some examples of sensory hypersensitivities are:

Sounds that you barely noticed before are alarming and startle you.

It feels like you have megaphones in your ears.

Background sounds and stimulating environments become overwhelming.

Fluorescent and bright lights give you headaches.

Clothing that was comfortable before feels irritating now.

Large gatherings of people feel overwhelming.

Pain and fatigue can intensify sensory hypersensitivities, putting you in a hyper-sensitive or hyper-vigilant state. When you are in a hyper-sensitive or hyper-vigilant state, even subtle stimulants feel overwhelming. Especially sights and sounds that didn’t bother you before, may now trigger anxiety and the fight-or-flight response where your whole being feels threatened and out of control. You may shut down and not be able to do any more or you may feel compelled to escape from the situation. It can be very taxing, physically and mentally.

Stress management, movement and using all of your senses can help your brain organize and integrate the senses. This is similar to what children do. Consider how physically active children are as they grow and develop!

See Brain Recharging Breaks at the end of this chapter for some basic meditation techniques. Meanwhile, following are suggestions for coping with sensory hypersensitivities.

General Coping Suggestions

Limit exposure to avoid sensory overload.

Avoid crowds and chaotic places where there are a lot of stimuli, like shopping malls.

Do shopping and errands early in the week and early in the day, when stores are less crowded and quieter.

Shop in smaller, quieter stores when possible.

Eat out in restaurants when they are quieter, in between regular meal times.

Hold conversations in a quiet place.

Ask people to please speak one at a time. Explain that you’d really like to hear what everyone has to say but you can only hear one person at a time.

Sleep during car trips.

If you want to attend a function that you expect will be taxing, plan to stay only a short while. Take your cap, sunglasses and earplugs. Sit towards the back to minimize the sound and where you can easily exit to a quieter place or the car.

Monitor your pain, stress and fatigue levels.

Lights and sounds will bother you the most when you are stressed or fatigued. If you are feeling especially sensitive, use it as a cue that you need to take a break and use some relaxation techniques.

Try avoiding nicotine, caffeine and alcohol.

They may make the symptoms worse. If you have vertigo, try limiting your salt intake, which can cause fluid retention. Consider strengthening exercises for your neck with the guidance of a physical therapist.

When you are starting to feel stressed or anxious, try incorporating another sense.

Put something in your mouth to chew or suck on. Strong flavors like peppermint or cinnamon are especially effective.

Put on some soothing music.

Apply some deep pressure. Give yourself a hug or press your palms firmly together or on the table. Squeeze the steering wheel if you are driving the car.

Experiment with activities and alternative therapies that involve your senses.

Gradually increase your exposure and tolerance when using earplugs, sunglasses, etc.Don’t eliminate the senses completely or you set yourself up for super-sensitivity.

Specific Coping Strategies

Sensitivities to sound

Limit your exposure to noisy stores and loud situations like sporting events, the movie theatre and children’s school activities. Don’t participate or plan to stay for a limited amount of time. Sit on the outskirts so you can gracefully escape to a quieter place if needed.

Use earplugs, try different kinds, and carry them with you.

Use headphones for TV and music:

For others, when you don’t want to hear it.

For yourself, when you want to hear it better.

Minimize distractions from snacking while doing things like working in groups or playing games. Use bowls for food instead of eating directly from noisy bags.

If your sense of smell is altered, make sure to have functioning smoke and gas detectors in your home.

Doing cognitive work

Plan to do cognitive work when your environment is quiet. Eliminate as many distractions and interruptions as possible.

Screen out distractions by using earplugs or headphones, playing soothing music, or using a fan or white noise machine if you have sensitivities to sound.

Turn down the volume on the phone and let the machine get it.

Work in an uncluttered space or use a three sided table screen, to help screen out visual distractions.

Give children headphones for the TV if you are having trouble screening it out.

Do your “thinking” work while children are in school or asleep.

Still having trouble concentrating? Try bringing in another sense.

Put on some soothing nature or instrumental music, something without words at a low volume.

Try chewing or sucking on something while you are working. Coffee stirrers can substitute for fingernails. Strong flavored or fizzy candies and gum can aid alertness.

Try using some deep pressure by giving yourself a hug, pressing your palms strongly against each other or on the table.

Try sitting on a large therapy ball while you work. A great strategy if you have trouble sitting still!

Take a physical break, every 15 min. at first. Resist the urge to push through. I know it feels counter-intuitive but taking breaks will actually help you work longer! Gradually you will find you can increase the time between breaks.

Use a timer - without a ticking sound!

Pause and stretch, drink some water or make a cup of tea, walk around the house or the yard, rock in a chair, walk the dog, pat the cat.

Visual Processing Problems

Vision is an extremely important and complex source of sensory information. What you see with your eyes travels through your brain to the back area of your brain, where it is processed in the occipital lobe. There is a lot of territory between the eyes and the back of the brain where an injury can occur. The occipital lobe may be damaged directly from impact to the back of the head or it may be damaged indirectly from the ricochet of the brain inside the skull when the front of the brain is impacted. Damage to the occipital lobe frequently occurs in car accidents, falls and sports injuries. Even subtle visual problems following a brain injury can have a significant impact on cognition and functioning.

I wish I had known about visual problems and visual therapy when I had my car accident. I thought I was really going crazy! Fortunately for me, my issues improved with time but not without mishaps, like falling off a curb!

Some common problems after a brain injury related to vision include:

Double vision

Trouble tracking words on a page

Impaired depth perception

Hypersensitivities to light

Difficulties remembering and recalling information that is seen

Difficulties “filling in the gaps” or completing a picture based on seeing only some of the parts

Trouble seeing objects to the side

Low tolerances to changing light or clutter

Impaired balance, bumping into objects

Feeling overwhelmed when there is a lot of visual stimuli

If you notice problems in areas related to visual processing, please consult a visual therapist or a neuroopthalmologist, they can help!

Tips:

Don’t eliminate any sense completely or you set yourself up for a super-sensitivity.

Be patient, in many cases your sensory hypersensitivities will decrease in time!

Ask for physical therapy or occupational therapy with a therapist with a background in sensory integration for help with sensory sensitivities.

Some good news about sensory hypersensitivity is that it is also associated with a heightened sense of awareness and intuition. You may find that you feel more aware of your intuition and more creative since your brain injury. This is not uncommon. Enjoy!

Brain Recharging Breaks

If I had to choose one strategy that helped me the most after my brain injury, it would be learning to meditate. Meditation is especially helpful when you are experiencing sensory overload. It can help you calm yourself down from that hyper-sensitive state. It was also the only way I have found to give my brain a rest, to put it temporarily in a “cast”, like you would a broken limb. Often, after meditating for 15-20 minutes, the “logjam” in my brain clears up and I am somehow able to think again!

I recommend using some stress management or meditation techniques at least once a day. Plan it, schedule it in your planner, make it part of your daily routine. Meditation is not as mysterious as you might think. Try these basic steps:

Get in a comfortable position on the bed, in a recliner or even in the car; uncross your arms and legs. Cover yourself with a blanket if you are cool.

Repeat for your eyes, ears, jaw, throat, back of neck, shoulders … down to your toes. Breathe in relaxation, breathe out stress and pain.

Notice how you feel after you get to your toes!

Visualize or imagine yourself in a warm, secure, relaxing, happy, peaceful place; floating on a cloud, floating in the water, or recalling a happy memory.

Continue slow deep breathing.

Focus on a picture or artwork that you like, noticing each detail.

Continue slow deep breathing.

Listen to music, any music that is soothing to you. Nature sounds or instrumental music is a good place to start experimenting.

Continue slow deep breathing.

Use aromatherapy – any scent that smells good to you. Favorite scents are often from childhood memories!

Continue slow deep breathing.

Strive to let go of that never-ending tape of worries and “shoulds” that plays in your head. Focus on your senses – your breath, the music, a relaxing place, a comforting aroma. If thoughts drift in, gently push them away. It gets easier with practice, you’ll find what works best for you and you’ll be amazed at how much it helps you!

If you find these suggestions helpful and you want to learn more, check out classes in meditation, yoga, Tai Chi, and Qui Gong. Local medical facilities and high schools often offer classes at reasonable rates.

There are television programs that demonstrate different practices as well as a variety of DVDs you can rent from your local library to get an idea of which discipline suits you best.

I love all this information. I got my TBI in May of 1976. I had to learn about my disability by my mistakes. Back in that day, my parents focused on the fact that I survived a motorcycle accident, they didn't SAY anything about the TBI. I was in a coma for 4 weeks. A seniors in High School, I was 18 but had the reactions of a baby.
I am so pleased that there is information for people who need it. I am now post 42+ years TBI.
Thanks for letting me share, Bobbie Bares

Being a very logical person, it took me a long time to finally admit that I was dealing with a TBI and chronic fatigue issues before that. In the past doctors couldn't find anything wrong in tests - other than sensitivity to light, sounds, smells, etc. I finally agreed to try a naturepath, which really went against my rational personality, and was given some vitamins to take - E manganese and a B cataplex, though needs vary from one person to another. I very skeptically took them but have been a changed person since then. I still have issues when I've overdone it, but they aren't nearly as extreme as they used to be.

Yes the after effects of TBI with the heightened sensory to light and sound is very frustrating. I too just take it one day at a time. Noise cancelling headphones along with yellow tinted prism glasses have been an effective strategy to be able to be more integrated back into society. Taking it slow and appreciating the small accomplishments I have achieved thus far. Keep working to be the best I can and knowing when to take a step back. Good Luck to all this is possible to work through and accept and love you again!

Lots of Omega's and try something called Alpha Stim with a doctors approval and prescription. It has worked for my husband and given him about 90% improvement with sensory overload. His hat, earplugs and glasses are almost never used these days except when he is fatigued. It has been almost 3 years since his bike accident that gave him a TBI and changed his life forever. Best wishes to all!

Hi there, Thank you for your comment. My sister had an car accident 5 yeas ago resulting in some brain trauma. The result is that she suffers from acute sensitivity to light and sound often wearing earplugs and sunglasses, and gets headaches easily. Her scar from surgery gets starts to hurt with “too much” stimulation of light, sound, concentration.

May I ask whether your husband had similar issues and if Alpha Stim provided relief and how?

I had one major and one very minor concussion b/c of being sensitive after the first one over a yr and a half. Just as I was getting better. My one word of advice is to go to a Neuropsychologist and also a behavioral optometrist. In addition to what's here, take LOTS OF OMEGAS, Magnesium (for mood) and serotonin, B Vit's and get your hormones and endocrine levels checked. They all play into your brain's recivedy and become altered after a concussion or TBI.

Anger seems to grab hold of me. I almost throw a tantrum, unreal! I have changed here, and hate it. I am trying to see a psychologist, but car insurance wants information released or they refuse to pay. And I thought it was just one on one knowing, unless suicidal. I am trying to figure out a way to control anger. Some of me it's being able to be flexible... that's so hard. I have to get that working again. Does anyone have some ways to calm down or run or What before I explode? Thank you

I have a friend who had a motorbike accident and had anger management problems. He used a boxing bag to release and control his anger. basically directing it into something he could control is what he was doing. Its all about getting control back. After my car accident I got control back from ninjitsu, a marshal art I learned 20 years earlier. that got me out of a wheelchair, now I can walk again. So I suggest boxing or some other marshal art, it will give your control back.

I have a problem with anger if I am tired. I can't cope when my brain wants to rest. It's hard but take note when the anger gets to you most. Self talk through the worst part helps. Ask yourself if the problem is life threatening. That is really the only issue that should get a response like anger. The rest just take your hands and go through the act of dumping the problem over your shoulder. It helps to get ride of the anger. My husband will say cranky cranky to me when I don't notice I am short tempered. That's his way of telling me without me really get angry. I then take a few minutes of relaxation and it usually passes. This article has excellent suggestions for relaxation. Good luck to you and you're not alone.

My grief/anger had me so wound up I didn't know if I was coming or going. My psychiatrist upped my anxiety & depression meds until I could get though dealing with insurance, doctors, etc. Now that I've come through it I want you to know that anger burns a lot of energy that could have been invested in my recovery.

I also have noise cancelling headphones....expensive but well worth it. They have allowed me to attend some sporting events and tolerate stores for longer periods. I always try to carry them with me when I go out. Some days I am fine at home but as soon as I am out in public places I become overwhelmed, confused and anxious from all the input(people, conversations, overhead lights, fans, CONSTANT MUSIC everywhere, millions of buying choices, etc.)

I have experienced 5 brain surgeries and 4 severe falls to my head. I look completely normal, but people just don't understand when I need to remove myself from a situation. People don't understand brain injury. Most folks only understand the disabled who are visibly affected. I live in a town that has absolutely no support for this silent disability. Thank You for posting this article.

Thank you to Barbara Webster for this extremely helpful book/excerpt and to brainline.org for posting it! I developed these sensitivities about 10 years after brain tumor surgery (I am a 16 yr. survivor). These helpful strategies include some of the ones I had developed as well, and I really appreciate the others. I have also used noise-reduction headphones which have felt life-saving at times!

This program is made possible in part by a grant from the Bob Woodruff Foundation, which is dedicated to ensuring that impacted post-9/11 veterans, service members, and their families are thriving long after they return home.